title: Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years.
abstract: OBJECTIVE
  Some small studies suggest that maternal postnatal depression is a risk factor for offspring adolescent depression. However, to our knowledge, no large cohort studies have addressed this issue. Furthermore, only 1 small study has examined the association between antenatal depression and later offspring depression. Understanding these associations is important to inform prevention.
  
  
  OBJECTIVE
  To investigate the hypothesis that there are independent associations between antenatal and postnatal depression with offspring depression and that the risk pathways are different, such that the risk is moderated by disadvantage (low maternal education) with postnatal depression but not with antenatal depression.
  
  
  METHODS
  Prospective investigation of associations between symptoms of antenatal and postnatal parental depression with offspring depression at age 18 years in a UK community-based birth cohort (Avon Longitudinal Study of Parents and Children) with data from more than 4500 parents and their adolescent offspring.
  
  
  METHODS
  Diagnosis of offspring aged 18 years with major depression using the International Classification of Diseases, 10th Revision.
  
  
  RESULTS
  Antenatal depression was an independent risk factor. Offspring were 1.28 times (95% CI, 1.08-1.51; P = .003) more likely to have depression at age 18 years for each standard deviation increase in maternal depression score antenatally, independent of later maternal depression. Postnatal depression was also a risk factor for mothers with low education, with offspring 1.26 times (95% CI, 1.06-1.50; P = .01) more likely to have depression for each standard deviation increase in postnatal depression score. However, for more educated mothers, there was little association (odds ratio, 1.09; 95% CI, 0.88-1.36; P = .42). Analyses found that maternal education moderated the effects of postnatal but not antenatal depression. Paternal depression antenatally was not associated with offspring depression, while postnatally, paternal depression showed a similar pattern to maternal depression.
  
  
  CONCLUSIONS
  The findings suggest that treating maternal depression antenatally could prevent offspring depression during adulthood and that prioritizing less advantaged mothers postnatally may be most effective.
authors.affiliation: Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, England.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Pearson
authors.forename: Jonathan
authors.initials: J
authors.lastname: Evans
authors.forename: Daphne
authors.initials: D
authors.lastname: Kounali
authors.forename: Glyn
authors.initials: G
authors.lastname: Lewis
authors.forename: Jon
authors.initials: J
authors.lastname: Heron
authors.forename: Paul G
authors.initials: PG
authors.lastname: Ramchandani
authors.forename: Tom G
authors.initials: TG
authors.lastname: O'Connor
authors.forename: Alan
authors.initials: A
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004522:Educational Status; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012307:Risk Factors